What’s the big deal about big data?
Remember the days when you would see a patient and simply submit a claim to the insurance company and then wait . . .and wait . . . and maybe wait some more. Ah, the good old days when a standard patient encounter consisted of taking the patient’s vital signs, writing notes into the patient’s chart, handing the patient a written prescription, and waiting for the patient’s insurance company to pay for the visit. But since the introduction of Electronic Health Records (EHRs) and the ratification of the Patient Protection and Affordable Care Act, patient data has taken on an entirely new importance.
The success of the Patient Care Act relies heavily on the ability to capture, maintain, and manage coordinated data. The development and rapid adoption of EHRs has given clients [providers?]the ability to capture information more effectively. Third-party vendors quickly and securely share patient data with payers, who in turn reward practices and physicians with incentives to provide quantifiable, high-quality care.
Get on the same page Today, capturing data is a cumbersome task. Even in healthcare organizations that have EHR systems, data capture is a primary concern because there is no interface between the payer and the EHR. As important as sharing patient data is, it can also be a source of inaccuracies and time consuming for providers, payers, and third-party intermediaries.
Patient data is valuable to payers because it allows them to assess how effective a patient’s care is and what interventions are necessary to improve patient outcomes. Payers rely on data from insurance companies and prescription drug claims, but run into problems when the captured data from these claims are not the same.
Follow the money Payers drive healthcare reform because . . . they pay for it. Understanding data accurately and knowing the story behind the data will help to improve quality of care and patient outcomes. Payers can use this data effectively to identify gaps in care, potential or existing duplicate treatments, and opportunities to provide better care and prevention to improve patient outcomes.
Payers and providers both benefit from the use of electronic data capture. Providers are rewarded with reduced time and effort in capturing the data, which results in fewer interruptions in normal daily care schedules. Capturing and reporting the data in a timely and accurate format also provides a better opportunity to qualify for incentives. Providers will also see an increase in revenue due to the payers’ rewards-based outcomes programs. When clinical outcomes results — such as reduced hemoglobin A1C levels for diabetic patients, more effective control of blood pressure, smoking cessation, or weight loss — are improved, these interventions are recorded in clinical indicators, resulting in increased revenue for providers.
Patients benefit because providers are in a better position to educate and guide them to healthier lifestyles, which in turn can improve wellness and potentially reduce insurance costs.
How NextGen® Ambulatory EHR can help Adopting an EHR program will help buyers to gain the incentives offered by payers. Patient care organizations that have already adopted an EHR program can talk to their payer about how to share data, and to their EHR vendor about whether that data can be provided in an electronic format.
NextGen Healthcare makes data capture less of a chore Patient data can be captured right inside NextGen® Ambulatory EHR, manually with the NextPen®, and through the Continuity of Care Document (CCD) format. This makes it easier for providers to deliver — and for payers to receive — data. Data can be captured in the Health Quality Measures application, as well as in the basic EHR.